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Original Article

Efficacy of perianal nerve blockfor day care ano-rectal procedures

Manoj Kumar Sharma, Ashish Vadhera, Madhusudan Dey, Gouriprasad Kurumapu

   

Abstract
Aim of this study was to assess patient safety, comfort, satisfaction level and quality of anaesthesia in patients undergoing day care ano-rectal procedures performed under Perianal Nerve Block (PNB) in comparison with Spinal Anaesthesia (SA) in peripheral medicare settings. MATERIAL AND METHODS: The study was a prospective, single centre study performed over a period of two years on 65 patients scheduled for various day care ano-rectal procedures. The patients were randomized to receive PNB or SA. The PNB was established using a mixture of 20ml of 2% lignocaine Hydrochloride (plain) and 20ml of 0.5% Bupivacaine Hydrochloride (plain) by four point perianal injection with Perianal subcutaneous infiltration augmentation technique whereas in all SA patients, the spinal block was established using 2 ml of 0.5% Bupivacaine (heavy) using 25G spinal needle in sitting position. All patients received premedication in the form of Inj Glycopyrrolate 0.2mg/iv and Inj Ondansetrone 8mg/iv. Patients were thereafter evaluated for pain and discomfort during the establishment of anesthesia, per-operatively and postoperatively for three days using a 10 point Visual Analogue Scale (VAS) and patient satisfaction level (1-5 point score). RESULTS: A total population of 65 patients out of 90 was found eligible for the study and were divided into two groups to either receive spinal anaesthesia (SA group, n=33) or Perianal nerve block (PNB group, n=32). Mean VAS during establishment of nerve block was 3.625 in PNB group and 1.2424 in SA group. Intra-operatively, VAS score was not very significantly variable in both the study groups. Mean VAS for post-operative pain during initial 12 hrs was 2.437 in PNB group and 5.878 in SA group.(P

Key words: Perianal nerve block, spinal anaesthesia, anorectal surgeries, pain relief, satisfactiony

Med-Science. 2018; 7(1): 182-185

Medicine Science Vol:7 Issue:1 Year:2018 PP:1–246
Posted in Vol: 7 Issue: 1 Year: 2018 March pp: 1–246

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